Question: Are there any drugs that interfere with cortisone metabolism or measurement that I shouldn’t take while I am tapering off of replacement medication? Answer: A number of drugs interfere with cortisol metabolism including anti-seizure medications and anti-fungal medications. Growth hormone therapy may affect cortisol replacement. The measurement of cortisol in a blood test is… Continue Reading
Author Archives: kkc
Steroid Replacement and Illness
Question: I am on replacement cortisone following surgery and recently had an experience where I was really sick with an infection. I tripled my dose (to 60 mg) according to the instructions from my endocrinologist. I only ran a fever of 99, but felt much sicker. Will the higher doses of cortisone required during illness… Continue Reading
Replacement Steroids and Stomach Problems
Question: I am on cortisol replacement medication and just had a large ulceration in my stomach. Can cortisol replacement cause this? For those on replacement, what is the best pain medication for arthritis that will avoid stomach problems? Answer: One of the potential side effects of cortisol replacement (using prednisone or hydrocortisone, most commonly) is… Continue Reading
Replacement Steroid Dose After Menopause
Question: Does one require less hydrocortisone replacement after menopause? Answer: Female hormones (estrogens) do affect cortisol metabolism by increasing the binding of cortisol to carrier plasma proteins. When the estrogen levels decrease after menopause cortisol binding also decreases. In people with intact pituitary-adrenal function, cortisol secretion decreases and levels adjust automatically. However, if a person… Continue Reading
Replacement Steroid After Surgery and Tapering
Question: What medication is given following successful surgery for Cushing’s syndrome and is there a proper procedure for weaning a patient from replacement medication? Answer: During and immediately following surgery, the patient is usually placed on high doses of hydrocortisone, 200 to 300 mg/day. Beginning the day after surgery, I normally decrease the dose by… Continue Reading
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